Spencer’s Benefits Reports NetNews – February 26, 2016

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The National Health Law Program (NHeLP) has filed a friend of the court (amicus curiae) brief with the U.S. Supreme Court forZubik v. Burwell, whereby the Court will decide whether non-profit employers are able to deny their employees access to contraceptive services on religious grounds. The NHeLP brief was joined by the American Public Health Association, National Hispanic Medical Association, National Family Planning & Reproductive Health Association, National Women’s Health Network, Ipas, Asian Americans Advancing Justice, AAJC, Asian Americans Advancing Justice—Los Angeles, Asian & Pacific Islander American Health Forum, Black Women’s Health Imperative, and Christie’s Place, and it urges the Court to uphold the contraceptive coverage requirements contained in the Patient Protection and Affordable Care Act (ACA) (P.L. 11-148). The Supreme Court will hear the case on March 23, 2016….

As promised, Kentucky Governor Matt Bevin (R) informed CMS of his intention to dismantle KyNect, and the agency has responded with a list of considerations and action steps the commonwealth will need to take along with a commitment to help facilitate the transition to the federally facilitated marketplace (FFM). Meanwhile, Kentucky’s previous governor, Steve Beshear (D), has launched efforts to preserve what many consider his legacy by creating a nonprofit, Save Kentucky Healthcare….

Group health plan sponsors that provide prescription drug coverage to individuals eligible for Medicare Part D must disclose to the Centers for Medicare and Medicaid Services (CMS) whether the coverage is creditable or non-creditable. The disclosure obligation applies to all plan sponsors that provide prescription drug coverage, even those that do not offer prescription drug coverage to retirees. Calendar year plans must submit this disclosure to the CMS by February 29, 2016. For non-calendar year plans, the Creditable Coverage Disclosure is due to the CMS no later than 60 days after the beginning of the plan year….

The IRS has issued proposed regulations under Code Sec. 432(e)(9), as added by the Multiemployer Pension Reform Act of 2014 (MPRA), Division O of the Consolidated and Further Continuing Appropriations Act (P.L. 113-235), relating to the ordering requirements for the suspension of benefits in certain multiemployer defined benefit plans in critical and declining status. The regulations are proposed to be effective and apply with respect to suspensions for which an approval or denial is issued on or after final regulations are published in theFederal Register….

The Eleventh Circuit Court of Appeals determined that the accommodation to the Patient Protection and Affordable Care Act’s (ACA) contraception mandate requiring religious nonprofits to notify HHS directly or via health plans or third party administrators (TPAs) that they object to the mandate does not violate the Religious Freedom Restoration Act (RFRA) because it does not substantially burden religious exercise and is the least restrictive means of furthering a compelling government interest. The court also determined that the accommodation regulations do not violate the Free Speech, Establishment, and Exercise clauses of the First Amendment to the U.S. Constitution. In reaching the RFRA decision, the Eleventh Circuit joined seven sister circuits in upholding the mandate. However, it enjoined enforcement of the mandate pending a Supreme Court decision inZubik v. Burwell and other consolidated cases….

ACA has another good year with prescription drug savings and preventive care

Medicare beneficiaries continued to see savings as a result of the Patient Protection and Affordable Care Act (ACA) in 2015. Since 2010, when the health law was enacted, almost 11 million Medicare beneficiaries have received discounts totaling over $20.8 billion on prescription drugs. Additionally, in 2015 an estimated 39.2 million people with Medicare took advantage of preventive services made possible through the ACA….

A federal district court in California has found no basis for denying retroactive application of the Supreme Court decision inWindsor, thereby allowing a surviving same-sex spouse to pursue a claim for QPSA benefits. The case is significant because it would require a company to retroactively applyWindsor without first amending its plan, as required by IRS guidance….

Forty-six percent of employers have implemented or are continuing to look at private health insurance exchanges to offer health benefits for their covered populations, according to a survey of employers conducted by the Private Exchange Evaluation Collaborative (PEEC). Over the last few months, PEEC has polled employers for a broad study on their views and intentions related to exchanges. A second shorter study was conducted in January to gauge strategies in light of the two-year delay in the implementation of the excise tax….

In 2016, the average premium for an employment-based insurance plan is projected to be about $6,400 for an individual and $15,500 for families. The Congressional Budget Office (CBO) found that premiums for employment-based coverage approximately doubled for both types of coverage between 2005 and 2014. Average premiums for private, nongroup coverage are not quite as high, but those enrolled in nongroup coverage typically make higher payments when receiving care….

Despite already modifying their benefit plans last year, employers expect their healthcare costs to rise again in 2016, which will require additional changes, according to the Employee Benefits Trend Study released today by Wells Fargo Insurance, part of Wells Fargo & Company. Fifty eight percent of employers surveyed expect their medical plan costs to exceed the thresholds for the Affordable Care Act (ACA) excise tax, or “Cadillac” tax, which was originally to take effect in 2018, but has been delayed until 2020. Additionally, 70 percent of employers expect their budgets for benefit plans to increase, as human capital and health and productivity remain key issues for businesses to manage….

The March 2016 short-term, mid-term, and long-term applicable federal interest rates (AFRs) have been issued by the IRS. The March mid-term 175 percent AFR (Annual) rate, used to calculate interest charged to the funding standard account for underpayments of quarterly contributions under Code Sec. 412(m), is 2.59 percent….

Religious non-profits seeking an exemption from the Patient Protection and Affordable Care Act’s (ACA) mandate that employers pay for contraceptives as part of standard health insurance plans are gearing up for the March 23, 2016, hearing scheduled in front of the Supreme Court. In November, the Court consolidated seven cases challenging the birth-control mandate into one:Zubik v. Burwell. Unhappy religious organizations outside of the seven are not waiting for the Supreme Court’s decision to make their next move, they have already filed another petition before the Court….